Cervical VEMP tuning changes by Meniere's disease stages
Simon I Angeli1, Stefania Goncalves1
1Department of Otolaryngology-Head and Neck Surgery University of Miami, Miller School of Medicine Miami Florida U.S.A.
Laryngoscope Investigative Otolaryngology
|October 23, 2019
Summary
The cervical vestibular-evoked myogenic potential (cVEMP) 1,000/500 Hz amplitude ratio is higher in Meniere
Area of Science:
- Neuroscience
- Otolaryngology
- Vestibular System
Background:
- Meniere's disease (MD) is characterized by cochlear and saccular hydrops.
- Current diagnostic methods may not fully capture the dynamic changes in MD.
- Cervical vestibular-evoked myogenic potentials (cVEMP) assess otolith function.
Purpose of the Study:
- To investigate if the cVEMP 1,000/500 Hz amplitude ratio can differentiate stages of hydrops in Meniere's disease.
- To assess the utility of this ratio in distinguishing Meniere's disease from other vertigo conditions.
- To evaluate the ratio's effectiveness in differentiating active from stable Meniere's disease.
Main Methods:
- A case-control retrospective study involving 47 patients with unilateral Meniere's disease and 30 with non-MD vertigo.
- Patients were classified as active or stable MD at the time of testing.
- cVEMP testing was performed using 500 Hz and 1,000 Hz tone-burst stimuli; the 1,000/500 Hz amplitude ratio was calculated.
Main Results:
- The cVEMP 1,000/500 Hz amplitude ratio was significantly higher in Meniere's disease ears compared to non-Meniere's ears (P = .001).
- This ratio was also higher in active MD compared to stable MD (P = .0035).
- The ratio showed moderate diagnostic value for differentiating MD from non-MD vertigo (AUC = 0.716) and active from stable MD (AUC = 0.746).
Conclusions:
- The cVEMP 1,000/500 Hz amplitude ratio is elevated in Meniere's disease, particularly in active stages.
- This finding suggests the ratio reflects dynamic changes in saccular hydrops.
- The cVEMP ratio may serve as a useful biomarker for Meniere's disease progression and treatment response.
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